Soapbox: Obamacare doesn’t go far enough

A visit to a hospital is often nightmarish in just about any regard, and the nightmare transforms from physical to economical. The mail is no longer anticipated with friendly joy but is dreaded with thuggish horror. Even with insurance, the hospital might be viewed with extreme care and trepidation: Yes, it can be life-saving, but it can also be life-depriving if one is bound by long-term debt.

A recent study by the National Nurses United reports some U.S. hospitals charge patients at 10 times the hospitals’ costs. The average charge-to-cost ratio for Colorado is 315 percent, 24th in the country. If a hospital is charging 315 percent of costs, the community trust has been breached and it’s time to become smart shoppers. The Center for Improving Value in Health Care, or CIVHC, is trying to make health care more transparent in Colorado. Their data indicate hospitals in the Denver area may offer more competitive prices than hospitals in Larimer County. Maryland has the lowest average cost-to-charge ratio of 140.2 percent. Maybe a visit to Johns Hopkins is in order. It might be worth the combination of excellent health care combined with lower costs. It’s also possible to consider foreign options: An article in the New York Times by Elisabeth Rosenthal describes a U.S. citizen’s experience going to Belgium for a hip replacement for a complete cost of $13,700. This surgery would have cost around $100,000 in the U.S.

I lived in Australia for five years and France for two. People there don’t fear financial ruin due to medical conditions. I never met an Australian or French person who had any admiration for U.S.-style health care. I had to pay 1.5 percent and 5 percent of my incomes in Australia and France for Medicare and Social Security, respectively. For a visit to a physician in Australia, I had to pay about $25. In France, I had a hand surgery, and I remember receiving a bill a couple weeks after the surgery. I left the bill on my table for a couple days, afraid to open it. Finally, one evening, after a couple glasses of wine, I opened the bill — ha! I laughed at 42.75 euros. The most expensive part of the surgery was the cost of the train.

A universal system isn’t in the cards for U.S. citizens because we’re too enamored with capitalism a la Obamacare, which seems like a step in the right direction, but I think it relies too much on hope. Obama hopes enough young people enroll because the health care program’s success relies on their participation. I think of myself at age 20. Even if insurance only cost $50 a month, I would have balked. Today’s economy is much worse. One thing is certain, the insurance companies are going to insist on their bottom line of profit and growth. They will design coverages to suit their bottom line. Copays and deductibles will almost defeat the purpose of insurance. People will avoid checkups and treatments in order to avoid exorbitant health care costs. With little regulation of hospitals, physicians and pharmaceuticals, I don’t share Obama’s hope. I think if he had spent all of his energy on regulations, we’d at least have the foundation for a more citizen-friendly health care system.